Sequential treatment with nab-paclitaxel/gemcitabine (nab-P/Gem) followed by modified FOLFOX (mFOLFOX) improved outcomes in patients with metastatic pancreatic ductal adenocarcinoma (mPDAC), compared with the standard nab-P/Gem regimen, according to research presented at the ASCO 2022 Annual Meeting.

Sequential nab-P/Gem-mFOLFOX improved overall survival (OS), progression-free survival (PFS), and time to progression in the phase 2 SEQUENCE trial.

Researchers conducted this trial ( identifier NCT02504333) to compare nab-P/Gem-mFOLFOX with standard nab-P/Gem in the first-line treatment of patients with mPDAC. Of the 157 patients enrolled, 78 were assigned to receive nab-P/Gem-mFOLFOX and 79 to nab-P/Gem.

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The median OS was 13.2 months in the nab-P/Gem-mFOLFOX arm and 9.7 months in the standard arm (hazard ratio [HR], 0.676; P =.023). The 12-month OS rate was 55.3% and 35.4%, respectively (P =.016).

The median PFS was 7.9 months in the nab-P/Gem-mFOLFOX arm and 5.2 months in the standard arm (HR, 0.516; P <.001). The median time to progression was 9.5 months and 5.3 months, respectively (HR, 0.462; P <.001).

Rates of grade 3 or higher adverse events (AEs) were generally comparable between the arms. Grade 3 or higher AEs that were more common in the nab-P/Gem-mFOLFOX arm were neutropenia (46.1% vs 24.1%; P =.004) and thrombocytopenia (23.7% vs 7.6%; P =.007).

Disclosures: Some study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of disclosures.


Carrato A, Pazo-Cid R, Macarulla T, et al. Sequential nab-paclitaxel/gemcitabine followed by modified FOLFOX for first-line metastatic pancreatic cancer: The SEQUENCE trial. Presented at ASCO 2022; June 3-7, 2022. Abstract 4022.